Priority Health Medicare policy updates
Track new and updated Priority Health Medicare policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| Disciplinary Action & Practitioner Appeal Policy | Priority Health Medicare | Administrative | — | Modified | Sep 8, 2026 |
| Hyperhidrosis | Priority Health Medicare | Clinical | Dermatology | Modified | Sep 1, 2026 |
| Septoplasty / Rhinoplasty | Priority Health Medicare | Clinical | Otorhinolaryngology (ENT) | Modified | Sep 1, 2026 |
| ALLERGY TESTING / IMMUNOTHERAPY | Priority Health Medicare | Clinical | Allergy/Clinical Immunology | Modified | Sep 1, 2026 |
| Medically Supervised Withdrawal Management (Detoxification) | Priority Health Medicare | Clinical | Psychiatry/Behavioral Health | Modified | Sep 1, 2026 |
| Moderate Sedation for Interventional Pain Management | Priority Health Medicare | Clinical | Pain Management | Modified | Jun 1, 2026 |
| Special Supplemental Benefits for the Chronically Ill (SSBCI) Medicare Only | Priority Health Medicare | Clinical | Other | Modified | Jun 1, 2026 |
| Advance Care Planning | Priority Health Medicare | Reimbursement | — | Modified | Nov 11, 2024 |
| Provider-Based Billing | Priority Health Medicare | Reimbursement | — | Modified | Jun 1, 2024 |
| Histotripsy for Malignant Liver Tumors | Priority Health Medicare | Clinical | Hematology/Oncology | Modified | — |
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.